DISABILITY DETERMINATION REDESIGN

Ohio will soon join other states in having a single disability determination system, simplifying the process for Ohioans to apply for and maintain health care coverage.

OVERVIEW

Ohio Medicaid is simplifying coverage for thousands of Ohioans who must currently “spend down” a portion of their income each month to be eligible for health care benefits. Beginning July 1, 2016, the income limit will be raised for these individuals.

  • Individuals will no longer need to “spend down” to a more restrictive income limit.
  • Individuals will no longer need to apply separately for SSI and Medicaid Benefits.
  • Medicaid coverage will be available to more low-income Ohioans.

All individual impacted by the change will have a pathway to coverage. Most will transition from one type of Medicaid coverage to another. In some cases, individuals with income that exceeds the new, higher Medicaid eligibility limit will be referred to the Federal Marketplace to obtain subsidized health care coverage.

The disability determination redesign is part of a comprehensive strategy to modernize the administration of Ohio’s Medicaid program. As a result of the disability determination redesign, Ohio will join the majority of states in having a single process for the application and determination of disability benefits.

INDIVIDUALS WITH A CHANGE IN COVERAGE

Most individuals who are aged, blind, or disabled and served by the Medicaid program will not notice a change in their coverage. Individuals who spend down to qualify for Medicaid will have a change in coverage when spend down ends on June 30, 2016.

Before any changes take effect, individuals who are impacted will receive a letter and a notice from Ohio Department of Medicaid via U.S. mail. The letter will have additional information about how their coverage is changing and, when applicable, what steps are needed to ensure health care coverage after June 30, 2016.

For more information regarding the Disability Determination Redesign and for Frequently Asked Questions and Answers please visit:
http://medicaid.ohio.gov/INITIATIVES/DisabilityDeterminationRedesign